Rare Surgeries

47-YEAR-OLD SUCCESSFULLY TREATED WITH BONE MARROW TRANSPLANT MEDICAL TOURISM RARE SURGERIES

In a ground-breaking procedure, Haematologists and Bone Marrow Transplant specialists successfully treated Anurag Mishra, a 47-year-old man from New Delhi, suffering from Multiple Sclerosis (MS) for the past seven years.

Multiple sclerosis (MS) is a life-long condition, known to reduce life-expectancy. MS affects the brain and spinal cord that leads to serious disabilities. The most common symptoms of MS include loss of sensation and balance, restricted arm or leg movement and vision loss in one or both the eyes.

Mishra, who was bedridden earlier and is back to his normal routines, was diagnosed with MS -- an autoimmune neuro degenerative disease, where the body’s own defence system starts attacking its nervous system without any specific reason.

Unlike the current line of MS treatment, which mainly includes steroid therapy, physiotherapy and symptom management, doctors used Bone Marrow Transplant (BMT). Dr Rahul Bhargava, Director, Department of Clinical Hematology & Bone Marrow Transplant, Fortis Hospital in Gurugram with his team performed autologous bone marrow transplant where they used Mishra’s stem cells for transplant, thereby reducing the chances of rejection and infections.

“In an autologous BMT procedure, the healthy stem cells from the patient are taken out and preserved. Chemotherapy is then administered to reset the body’s immunity and then the stem cells are injected back to rescue the person from the side effects of chemotherapy,” said Bhargava.

After the surgery, the patient is kept under isolation for a few months to ensure he/she does not contract any infection. “In this case, when Anurag approached us, he was entirely dependent on others for his basic needs. But within six months of the treatment, he is back on his legs and is carrying on with his normal life,” Dr. Bhargava added.

According to the patient, the attacks are sudden and may affect any part of your body, limiting your abilities. “Extreme pain and disabilities this disease gave was scary and left me depressed. I think I am very lucky to get to know about Dr Rahul Bhargava and team, who cured me miraculously,” Mishra said.

“Too much delay in the procedure can considerably affect the clinical outcomes. In the case of Anurag, recovery is 90 per cent, which means he received the treatment within recovery time-frame,” Dr Bhargava said.

ONE-YEAR-OLD UNDERGOES RARE LIVER TRANSPLANT SURGERY A 14-hour rare liver graft transplant surgery was performed on a one-year-old girl from Saudi Arabia at Artemis Hospital in Sector 51 in Gurugram in Delhi. Baby Fatima (name changed) underwent the living donor liver transplant, where only one out of eight portions of the liver was used to provide a new liver to her. The surgery called Monosegment (Segment 3) living donor liver transplant is the first such case reported in Delhi-NCR, in which mono-segmented liver graft has been used, the hospital said. “Apart from this, the use of bovine jugular vein in liver transplant has been reported for the first time in the world, to provide an inflow of blood to the newly transplanted liver as the baby was born with absence of bile ducts and underdeveloped portal vein,” the hospital said. Managing the child during such a long surgery was a tedious and tricky task for the doctors.

Born as the third child to her parents, Fatima suffered from unusually prolonged and deep jaundice for months after her birth. Doctors in Saudi Arabia diagnosed her with a rare disease called Biliary Atresia which is found in one in 16,000 live births. The developments of bile ducts in such children are absent.

HAEMOPHILIA PATIENT'S BLADDER RECONSTRUCTED IN BENGALURU HOSPITAL MEDICAL TOURISM RARE SURGERIES

AHaemophilia patient's urinary bladder was reconstructed through surgery at Fortis hospital in Bengaluru.

"The surgery was performed by a team of doctors on a 38-year-old overseas patient, diagnosed with cancer bladder though he was in a Haemophiliac," Fortis Urology Director Mohan Keshavamurthy said.

Touted to be the world's first surgical removal of the urinary bladder on a patient whose ability of the blood to clot is reduced, the doctors replaced his knee and reconstructed his anterior cruciate ligament.

"This was our first complex radical cystectomy (surgical removal of bladder) on a Haemophilia patient in two days despite challenges," said Dr. Keshavamurthy.

Haemophilia is a bleeding disorder where the patient suffers from defective clotting protein and requires external blood factors to avoid bleeding in case of an injury. The surgery required the bladder affected with Cancer to be removed and a new bladder reconstructed using the small intestine.

"The risk of bleeding while reconstructing the bladder is a challenge in such patients and care was taken to maintain absolute hemostasis," said hospital's Urology Consultant Dr. Karthik Rao.

According to hospital's director Dr. Niti Raizada, the country has an estimated 1 lakh Haemophiliacs although many others remain undiagnosed.

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CARE HOSPITAL PERFORMS RARE BEATING HEART SURGERY MEDICAL TOURISM RARE SURGERIES

Aspecialised team of cardiac surgeons at the CARE Hospital, Banjara Hills, Hyderabad, successfully performed a rare beating heart surgery recently. According to the doctors, the 45-year old patient Mohmmed Qutubuddin from Hyderabad, was afflicted with a rare congenital chest deformity. The upper part of his chest (sternum and adjacent costal cartilages) was protruding out (Pectus Carinatum) and the lower part of chest (sternum and costal cartilages) was sunken deep inside (Pectus Excavatum).

According to Dr Prateek Bhatnagar, Director of Cardiac Surgery, CARE Hospitals, Banjara Hills, this was a medically challenging case. “Worldwide, there is limited medical literature available on handling of such patients,” he said, explaining that in the case of this particular patient, he and his team of doctors performed the life-saving procedure through an extremely narrow passage in the chest.

angiography showed left main with multi-vessel disease. This was a rare situation because in such a chest deformity, there is very little space to conduct the surgery. Beating all odds, we performed the surgery without any blood transfusion.”

After assessing the patient’s condition in detail, Dr Bhatnagar devised the surgical strategy to perform this complex operation. Because of the extreme space reduction in Currarino-Silverman chest deformity, manipulating the heart during the surgery becomes very difficult, he explained, adding that due to the crooked nature of the breast bone (sternum), retraction of this bone to harvest internal mammary arteries (IMAs), using routine techniques during a bypass surgery becomes impossible.

“We are currently verifying from medical literature if this is the first ever such case wherein the patient has been successfully operated upon. Post the surgery, the patient is recovering well. The patient was walking independently within 24 hours of the bypass surgery,” Dr. Bhatnagar said.